Dear Melissa,
I just started noticing my 18-month-old daughter "W" sitting today.
When is there cause for concern?
To address your question I have invited Shannon McIvor (PT, DPT), a member of our fantastic TEAM physical therapy department, to be a guest writer this week. She shared the following response to your question:
Don't worry...
If your daughter occasionally transitions through w-sitting when playing, then don't worry. It is not uncommon for kids to transition through w-sitting to achieve a new position. This posture may sometimes be used for stability and balance while playing. There are many positions of sitting that a child may use throughout the day. In addition to w-sitting, these may include ring sitting, sitting on heels in a low kneel, taylor sitting (criss-cross applesauce), long sitting with legs in front, side sitting, etc.
It is a concern...
If you notice that w-sitting seems to be your child’s only means of sitting and she has great difficulty with other sitting positions, this should be brought to the attention of your pediatrician. If your child uses w-sitting more frequently than other positions, then she may simply need frequent cuing to change position.
If a child frequently w-sits, then...
She may be predisposed to hip dislocation and knee conditions later in life. Therefore, w-sitting should be discouraged in all children, but especially in children with diagnosed developmental delay, lower extremity orthopedic concerns, changes in muscle tone, or a diagnosed neurological condition.
Be proactive.
The easiest way to
prevent this sitting posture, and any long-term problems that it may cause, is to not allow it to become a habit in the first place. This is particularly important when your
child is first learning how to sit. Promoting other sitting positions and having your
child practice various positions will enhance their trunk control and abdominal
strength. Provide cues, again, again, and again.
For older children who have already turned to w-sitting as their “go-to” sitting position, persistent verbal cues of “fix your legs” will be a frequent phrase heard in the household, preschool, school, daycare, after-school care, etc. This may mean that the child starts with side-sitting, allowing one leg to still be behind the body, or pulling her legs closer together and turning her feet in to sit on her heels. Eventually she transitions to ring sitting or pretzel sitting (criss-cross applesauce) as a more proper means of floor sitting. Consistency and persistence from family members and caregivers throughout the day will eventually assist children into a sitting position that is better for their knees and hips.
How a pediatric PT can help.
A pediatric PT can work with families to support the transition to healthier seating postures. They can work with a child directly to strengthen their hips and abdominals. This will assist in obtaining and maintaining other seated positions. PTs can also provide individualized guidance for families given the child's specific needs.
Helpful Resources
Zero to Three Development, National Center for Infants, Toddlers and Families (2014)
Does your child W-Sit?, Donna Greco, Physical Therapy and Rehab (1999)
What's Wrong with "W Sitting" in Children, Jaime Ruffing, Early Intervention Support, www.earlyinterventionsupport.com (2014)
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Thank you Shannon for guest writing this week!
Your expertise is greatly appreciated.
Your expertise is greatly appreciated.
Parents:
Please feel free to share your questions or comments at: share@childrenstherapyteam.com
I love hearing from you!
